Open heart
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Observer variability can influence the assessment of CT coronary angiography (CTCA) and the subsequent diagnosis of angina pectoris due to coronary heart disease. ⋯ Multicentre multidetector CTCA has excellent agreement in patients under investigation for suspected angina due to coronary heart disease.
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Palliative care (PC) in heart failure (HF) is beneficial and recommended in international HF guidelines. However, there is a perception that PC is underutilised in HF in the UK. This exploratory study aims to investigate, from a PC perspective, this perceived underutilisation and identify problems with current practice that may impact on the provision of PC in HF throughout the UK. ⋯ Low HF referrals despite widespread availability of PC services and insufficient efforts by cardiology to address PC issues may contribute to the perception that PC is underutilised in HF. The challenges facing PC and HF identified here need to be further investigated and addressed. These findings will hopefully promote awareness of PC issues in HF and encourage debate on how to improve PC support for this population.
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The study aimed to (1) establish the incidence of exercise-related sudden cardiac arrest (SCA) in London, (2) investigate survival from exercise-related SCA and (3) examine factors related to survival. ⋯ Incidence of exercise-related SCA in the general population in London is rare. Survival following exercise-related SCA was considerably higher than survival for all OHCA with presumed cardiac aetiology and resuscitation attempted attended by the LAS during the same period. The major limitation of the study is the likely under identification of cases of exercise-related SCA.